Relocating to a foreign country will always raise concerns about healthcare… How does the new health system work? What is the quality of care like? Will your current health insurance be accepted in the new country?
These same questions are commonly asked by newly arriving expats in the Netherlands. Understanding the health insurance requirements stipulated under Dutch law is especially important, since not complying with it could result in a substantial fine.
To help avoid such a situation, we contacted Remko van der Zwart, Director of LoonZorg, a Dutch health insurance specialist, with ten questions about Dutch health insurance. Here is what he had to say…
1. When an EU citizen moves to Holland for an expected stay of less than three months, are they adequately covered by the health insurance plan they have with a provider in their home country?
- RvdZ: For every person that resides or works in The Netherlands, it is usually compulsory to take out health insurance by a Dutch health insurer. Sometimes exceptions are made.
2. Are Dutch health insurance requirements different for Holland expats coming from outside the EU than expats who come from within?
- RvdZ: No, the same rules apply to everybody; the standard package (called ‘Basisverzekering’) does not differ in content no matter where you come from. The content or coverage of the Basisverzekering policy is determined each year by the Dutch government.
3. When an expat moves to Holland for a position with a multinational corporation or an NGO, is it common for the company or organization to offer one or more health insurance plan options? If so, are the costs to the employee usually lower than what a private person would have to pay for the same insurance plan? In other words, do most big companies here in Holland subsidize a portion of employee health insurance?
- RvdZ: Employees of larger companies are commonly offered a premium discount by the insurance companies via the employer. Legally, the maximum discount that can be offered on the cost of the Basisverzekering (standard package) is 10%.
4. Health care in the Netherlands is regulated by the Dutch government. What department within the government is specifically involved in healthcare?
- RvdZ: The primary organization responsible for Dutch healthcare regulation is Zorginstituut Nederland, an agency within the Ministry of Health, Welfare and Sport.
5. Are the costs of common procedures, such as a blood test or dental checkup, fixed by the government or are the care providers free to charge what they want?
- RvdZ: In the Netherlands, the cost of common treatments is negotiated by health insurance companies and health care providers. For less common procedures, the allowable cost is set by the Dutch Healthcare Authority. Furthermore, this organization is also responsible for ensuring that the care providers are following standard rules and regulations for Dutch healthcare.
6. Are individual healthcare service providers connected to a specific health insurance network? For example, let’s say you purchase a health insurance policy from ZilverenKruis, do they have a list of their ‘network’ doctors that you must go to? If not, how does one generally go about finding a GP? Or a specialist such as a dentist or eye doctor?
- RvdZ: Most health care insurers contract with most service providers in the Netherlands. But sometimes disagreements on prices or quality does result in the termination of the contract with that service provider.
7. Is there a website in English that explains everything that is included in the basic Dutch health insurance policy?
- RvdZ: No, I am not familiar with such a website in English. The coverage of the Basisverzekering changes every year and is determined by the government, but this is always specified in Dutch.
8. What are some common healthcare procedures not included in the basic policy? And are there extended plan options that cover such treatment costs? Are the costs of these ‘non-basic’ procedures (for example, a vision test or dental exam) set by the government?
- RvdZ: Every health care insurer offers extended health insurance plans that cover, for example, physiotherapy, dental care and psychological care. Healthcare insurers are free to determine the content of their extended plans. This is not the case with the Basisverzekering (standard package). Also, healthcare insurers are not obliged to accept everyone who applies for their extended plan.
9. When discussing Dutch healthcare, expats frequently raise the issue of it being reactive rather than proactive. For example, in other countries, annual checkups (physical exams) are common once people reach a certain age, to screen for signs of cancer, diabetes, high cholesterol and high blood-pressure since these ailments tend to develop later in life. These kinds of proactive checkups aren’t very common here in the Netherlands. Is it a cost issue, in order to keep down the price of healthcare?
- RvdZ: My personal opinion and experience on this matter is that the Dutch people do not really use the opportunity to do annual check-ups even when it is covered (partly) in the standard package. For years I offered free ‘Fitchecks’ to employees of bigger companies in The Netherlands. Although it was free of charge very few people took advantage of it. Furthermore, the Dutch government does subsidise some annual check-ups, for example those with a family history of breast cancer.
10. When an expat worker leaves a company, does his health insurance continue until he ends it? Does the health insurer automatically start billing the individual directly? Does the cost stay the same even if he is no longer with the company? Or does the health insurance stop when the employee leaves?
- RvdZ: This is a very important issue in The Netherlands. When the contract ends most of the time the employer will also end the health insurance policy. It is very important that the employer tells the leaving worker that they need to obtain a new health insurance policy themselves if they are staying in the Netherlands. Those people that are leaving the company are also most welcome to call LoonZorg. We can offer them a new health insurance policy, along with discounts on both the standard and extended plans.
I hope my responses above are able to help your expat readers in finding their way here in Holland.